儿科器官移植候选人的天花和麻疹免疫不完全. 从传染病移植前诊所的真实世界经验
Heather L Daniels1, Charles B Foster1, Wei Liu2
1Center for Pediatric Infectious Diseases, Cleveland Clinic Children's, Cleveland, Ohio, USA.
Pediatric transplantation
|October 7, 2024
概括
许多儿科固体器官移植候选人缺乏对麻疹和水的免疫力. 提高疫苗接种率的努力只取得了部分成功,这凸显了在这个脆弱群体中需要更好的策略.
科学领域:
- 儿科免疫学 儿科免疫学
- 移植医学 移植医学
- 疫苗学 疫苗学 疫苗学
背景情况:
- 针对麻疹和水的疫苗接种对于儿科实体器官移植候选人来说至关重要,因为严重疾病的风险和移植后使用活疫苗的禁忌.
- 麻疹的全球复苏促使对实体器官移植接受者的指导方针得到更新,强调预防和暴露后管理.
- 这项研究评估了在提高意识期间移植候选人的麻疹和水的免疫水平和优化策略.
研究的目的:
- 评估小儿固体器官移植候选人中对麻疹和水的不完全免疫的患病率.
- 评估旨在通过额外的疫苗剂量优化免疫力的策略的有效性.
- 确定在这个高风险人群中实现及时接种疫苗的挑战.
主要方法:
- 从2012年到2016年进行了一项横截面研究,包括儿科实体器官移植候选人.
- 收集的数据包括疫苗接种史,血清学状况和人口统计信息.
- 不完整的免疫力是由不完整的疫苗接种计划或血清阴性定义的.
主要成果:
- 超过一半的91名候选人接种了不完全的小疫苗 (54.9%) 和麻疹疫苗 (30.8%).
- 血清免疫因年龄和疫苗接种状况而异,较小的儿童和不完整疫苗接种计划的儿童的免疫率较低.
- 接种推的额外疫苗剂量很低,只有31.1%接收额外的水剂量,28%接收额外的麻疹剂量.
结论:
- 儿童固体器官移植候选人的很大一部分对麻疹和水有不完全的免疫力.
- 尽管全球麻疹活动和具体指导方针增加了,但疫苗接种优化工作取得了有限的成功.
- 需要进一步的研究来制定有效的策略和克服障碍,以确保在这个脆弱的儿科群体中进行足够的移植前疫苗接种.
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